Abstract
Purpose
Some researchers have suggested that bone bruises are evidence of rotational instability. The hypothesis was that the extent of lateral bone edema is correlated with the presence of an anterolateral ligament (ALL) injury. The main objective was to determine whether there was a correlation between the presence of an ALL injury the extent of bone bruises.
Methods
A prospective diagnostic study enrolled all the patients who suffered an acute anterior cruciate ligament (ACL) who were operated on within 8 weeks. The extent of bone bruising according to the ICRS classification was measured on preoperative MRIs by two independent blinded raters twice with an interval of 4 weeks. Dynamic ultrasonography (US) to look for ALL injury and the pivot shift test were performed before the ACL surgery. The correlation between ALL injury and bone bruises, and the correlation between an ALL injury and a high-grade pivot shift test were determined.
Results
Sixty-one patients were included; 52% of patients had an ALL injury on US. The extent of lateral bone bruise was not related to the presence of an ALL injury, nor related to the presence of a high-grade pivot shift. A grade 2 or 3 pivot shift was significantly correlated with an ALL injury (p < 0.0001). Inter- and intra-rater reliability for the bone bruise rating was excellent.
Conclusion
The extent of lateral bone bruise is not correlated with ALL injury or a high-grade pivot shift; thus, it is not correlated with rotational instability of the knee.
Level of evidence
II.
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Change history
28 February 2021
A Correction to this paper has been published: https://doi.org/10.1007/s00167-020-06063-9
Abbreviations
- ACL:
-
Anterior cruciate ligament
- ALL:
-
Anterior lateral ligament
- BMI:
-
Body mass index
- CI:
-
Confidence interval
- ICC:
-
Intra-class correlation
- ICRS:
-
International Cartilage Research Society
- MRI:
-
Magnetic resonance imaging
- US:
-
Ultrasonography
- PD-FS:
-
Proton-density fat saturation
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The study was approved by the Toulouse Teaching Hospital (“CHU de Toulouse”) ethics committee (DRCI scientific board number 2019-03).
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Marot, V., Corin, B., Reina, N. et al. Femoral and tibial bone bruise volume is not correlated with ALL injury or rotational instability in patients with ACL-deficient knee. Knee Surg Sports Traumatol Arthrosc 29, 900–906 (2021). https://doi.org/10.1007/s00167-020-06045-x
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DOI: https://doi.org/10.1007/s00167-020-06045-x